In 2010, Congress passed and President Obama signed the Patient Protection and Affordable Care Act. CDA was pleased to see pediatric dental benefits included as one of the Act’s Essential Health Benefits that will be offered.

CDA-sponsored Senate Bill 1008 (Skinner, D-Berkeley), which calls for more value and transparency from dental plans, is moving swiftly through the Legislature. The bill in late May passed the Senate with bipartisan support despite strong opposition from the dental plan lobby. SB 1008 supports patient choice of provider and helps level the playing field for providers and patients.

Assembly Bill 3087 was held in the Assembly Appropriations Committee May 25 and will not move forward in the current legislative session. As CDA first reported in April, AB 3087 would have created a new government commission of appointed members to regulate and cap commercial payment rates for health care providers. The Assembly heard the strong concerns raised by CDA and a large coalition of health care providers, including through direct member advocacy and grassroots efforts.

CDA last week became aware of a bill that seeks to regulate and cap provider rates to a percentage of Medicare. Assembly Bill 3087 raises significant concerns about fracturing the market and undermining the ability of providers to balance their patient mix. CDA joins a number of other major provider groups representing a wide range of California health care professionals in voicing deep concerns about AB 3087 and issued a statement from CDA President Natasha Lee, DDS.

If enacted, Assembly Bill 2643, co-sponsored by CDA and the California Society of Pediatric Dentistry, would require medical insurance plans to cover general anesthesia costs in the dental office setting when a patient’s developmental or other physical condition prevents that patient from receiving dental treatment unless deeply sedated but does not necessitate a hospital setting for care.

New legislation sponsored by CDA and introduced by Sen. Nancy Skinner (D-Berkeley) is working to increase value and transparency of dental benefit plans. Senate Bill 1008 calls for the establishment of a minimum dental loss ratio for individual, small and large group dental benefit products and requires increased transparency for consumers who purchase dental savings or dental discount products by requiring standardized disclosures of what a dental benefit plan does or does not provide.

CDA has joined a broad coalition of more than 100,000 California physicians, dentists, nurse practitioners, community clinics and pharmacists in a new effort to protect the gains California has made under the Affordable Care Act and improve California’s health care system. The Coalition to Protect Access to Care will actively oppose efforts in Washington to repeal and replace the ACA, which would strip health insurance from millions of Californians.

A last-ditch health care bill to replace the Affordable Care Act failed to advance in the Senate prior to the Sept. 30 budget reconciliation deadline. CDA, the California Medical Association and California Hospital Association sent letters to members of the California congressional delegation asking them to oppose the Graham-Cassidy Block Grant amendment to the American Health Care Act due to the negative implication for Californians.

In response to goals identified in the draft California State Oral Health Plan, CDA this year co-sponsored Senate Bill 379, co-authored by Toni Atkins. The bill makes statutory updates that will facilitate the efficient collection of oral health data at schools. SB 379 also enables schools to facilitate screenings by streamlining the consent process for on-site oral health assessments.

More discussion is in store for Senate Bill 501, the CalAOMS-sponsored legislation introduced by Sen. Steve Glazer (D-Orinda) early this year and supported by CDA to improve safety in pediatric dental anesthesia.

CDA along with the California Medical Association and California Hospital Association sent the following letter to members of the California congressional delegation asking them to oppose the Graham Cassidy Block Grant amendment to the American Health Care Act.

Five years after CDA developed a proposal to reduce barriers to dental care in California, several of the proposal’s objectives have come to pass. Most notably was the 2015 installation of Jayanth Kumar, DDS, MPH, as state dental director. And now, thanks in part to the passage of Proposition 56, the state oral health plan that CDA and other stakeholders helped develop over the past year will receive a significant financial boost of $30 million annually.

CDA continues to monitor Congressional efforts in Washington D.C. to repeal or replace the Affordable Care Act. After several failed attempts by the Senate in late July and early August to pass repeal/replacement proposals, both chambers of Congress are working toward finding a bipartisan solution to stabilize the individual health coverage market.

Of the three bills introduced in the Legislature early this year to improve safety in pediatric dental anesthesia, only Senate Bill 501 (Glazer, D-Orinda), which CDA supports, will advance in the current legislative session. The Assembly Business and Professions Committee on July 11 passed SB 501 on a bipartisan, unanimous vote.

A new analysis from the California Department of Health Care Services and the Department of Finance finds that California could face more than $30 billion annually in additional health care costs over the next decade under the Senate proposal to repeal and replace the Affordable Care Act. The Senate bill, called the Better Care Reconciliation Act (BCRA), would increase state costs even more than the $24.3 billion estimate under the House’s American Health Care Act proposal. A comparative chart offered here outlines the current proposals and the implications nationally.

The House of Representatives’ vote May 4 to approve the American Health Care Act is the first step down a long, winding road of a possible repeal or replacement of the Affordable Care Act. CDA and other health care organizations have expressed their concerns to policymakers that the AHCA would harm Californians due to the erosion of pre-existing condition protections, decrease patient access to physicians and dentists and cause over 3 million Californians to lose health care coverage.

Three bills that seek to improve safety in pediatric dental anesthesia are moving through the state Legislature, including CDA-supported Senate Bill 392 and Senate Bill 501. The three pieces of legislation passed out of policy committees following robust discussion at the Capitol, April 24-25, with CDA and other medical and dental organizations as well as individual stakeholders presenting testimony on the bills.

CDA has assembled a group of volunteer dentists to monitor the impact of federal ACA reform efforts on behalf of CDA members. Since December 2016, this workgroup has been gathering information and meeting regularly with policymakers to assess the potential impact on California dentists of all federal proposals to repeal, amend or replace the ACA. In addition, a course offered at CDA Presents Anaheim will discuss the potential impact of the ACA reform on consumers and the dental profession.

Making its way through the state Capitol is a key piece of legislation that, if passed, would improve infection control safety in dentistry. Assembly Bill 1277 calls for the Dental Board of California to amend the regulations on the minimum standards for infection control for certain dental procedures that expose the dental pulp and may create an opportunity for infection. CDA has taken a “support” position on the bill.

Senate Bill 379 (Atkins, San Diego), co-sponsored by CDA, would amend the law to improve both the quantity and quality of the oral health data collected. The statutory updates in the bill will also facilitate the efficient collection of the data by ensuring it is reported to one entity — the Office of Oral Health within the Department of Public Health.

Students’ oral health is receiving a big push in Los Angeles schools. The Los Angeles Unified School District Board of Education in January unanimously approved a resolution that seeks to enforce AB 1433, known as the Kindergarten Oral Health Requirement, by recognizing February as Children’s Dental Health Month, among other actions.

The new Congress and administration in Washington are negotiating legislation that would considerably dismantle the Affordable Care Act as one of their first objectives. While it remains to be seen what this repeal and replacement of the ACA will look like, one aspect of the ACA that will likely survive is the idea and objective of “affordable” health care.

The 2017 open enrollment period for Covered California, California’s health insurance marketplace for the federal Affordable Care Act, continues through Jan. 31. CDA reported in September on the partial list of participating dental plans for 2017. The complete list of providers, along with the 2017 embedded children’s dental plans, has now been released.

Under SB 137, which went into effect July 1, dentists contracted with dental plans must respond to a plan’s request for accurate directory information within 30 days or face payment delays, reimbursement reductions or termination of their participating provider agreement.

In the final weeks of the state’s 2016 legislative session, Gov. Brown signed into law several bills that impact dentists, including CDA-sponsored Assembly Bill 2485 (Santiago, D-Los Angeles). Taking effect immediately as an urgency statute, AB 2485, the Dental Corps Loan Repayment Program, revises in the applicant’s favor provisions regarding program eligibility, application, selection and placement.

Covered California, California's health insurance marketplace for the federal Affordable Care Act, has released some of the participating dental plans for the 2017 benefit year. Covered California's open enrollment period for 2017 coverage begins on Nov. 1 and ends Jan. 31, 2017.

Dentists interested in learning how to provide telehealth dental care can attend a lecture and workshop presented by Paul Glassman, DDS, MBA, at CDA Presents The Art and Science of Dentistry in San Francisco Sept. 8-10.

The 2016-17 budget, totaling $167 billion, was recently signed by Gov. Brown and includes $3.2 million for the restoration of the California Children’s Dental Disease Prevention Program, a school-based prevention program managed at the local level by local health departments, county superintendents and other contracted entities.

There is an ongoing trend within health care toward integration and consolidation of health care delivery systems. This trend is reflected in provisions of the federal Affordable Care Act, such as the envisioned coordination of care provided under a single entity, the “Accountable Care Organization.”

Enrollment in the family dental benefit plan product offered through Covered California, California’s health benefit marketplace created by the federal Affordable Care Act, now exceeds 144,000 enrollees according to Covered California representatives. Here is what dentists need to know.

Covered California, California’s health insurance marketplace for the federal Affordable Care Act, is now offering family dental plans to purchase for the 2016 benefit year. The standalone family dental plans are available in addition to the children’s dental coverage included as an essential health benefit for consumers younger than 19 years old.

On Jan. 1, California and the nation began the second year of implementation of the Affordable Care Act (ACA). Despite the fact that we are entering into year two, there is still much uncertainty regarding the overall and long-term impacts of the ACA on both the medical and dental care insurance and delivery systems.

As California approaches the second full year of implementation of the Affordable Care Act (ACA), California’s Health Benefit Exchange Board, responsible for Covered California, the state’s online insurance marketplace and for the overall implementation of the ACA in California, has announced some changes to how dental benefits will be offered in 2015.

In a new report from the ADA’s Health Policy Institute researchers found that the Affordable Care Act’s (ACA) expanded dependent coverage provision increased dental insurance coverage for young adults. The report, published in Medical Care, set out to "assess the effect of the Affordable Care Act’s dependent coverage policy on private dental benefits coverage, utilization and financial barriers to dental care."

While the Exchange has not yet released the number of pediatric dental benefit policies sold in its first open enrollment period, the agency continues to move forward with its plans for 2015. Medical plans as well as dental plans have submitted bids to the Exchange to participate and sell policies in 2015. Those bids are sealed, so we have little detailed information on them – including any dental plans that have asked to join the Exchange – but we know that the Exchange staff is actively negotiating with plans on the premium rates being offered by those hoping to sell products in the Exchange.

The ballot measure that would quadruple the cap on non-economic damages under the Medical Injury Compensation Reform Act (MICRA) has been assigned a number, Proposition 46, for the upcoming November election, while the campaign against it is gaining more powerful allies. CDA and an expanding coalition of health care organizations and others are working to defeat Prop. 46 because it would have devastating effects on California’s health care system, increasing costs by billions of dollars annually.

Interest remains high in the provisions of the federal Affordable Care Act (ACA) health reform law, as indicated by the attendance at a CDA PresentsThe Art and Science of Dentistry lecture in Anaheim on the ACA. CDA Legislative Affairs Manager Nicette Short presented “National Health Care Reform: How Will It Affect Your Practice?” — a course designed to provide information about the Affordable Care Act, its scope of coverage to individuals and small businesses and its potential impact on dentists, the oral health care delivery system and the dental benefits market.

CDA-sponsored legislation to require dental plans to adhere to the same administrative cost limitations as medical plans took a major step forward April 8. AB 1962 passed the Assembly Health Committee on a 15-3 vote over strong opposition from the dental plan industry. AB 1962 would remove the dental plan exemption from state law that requires health plans to allocate a minimum of 80 percent of their premium revenue to actual patient care.

Even with the rollout of the Affordable Care Act (ACA) barely under way, Covered California, the agency charged with implementing the ACA in this state, devoted considerable time last month to planning for expanded dental benefit offerings for 2015. CDA has continued to push for making a variety of plan options available to all consumers, including adults, and the state is now moving in that direction, with many details still to be worked out.

There is still much uncertainty regarding the overall and long-term impacts of the Affordable Care Act (ACA) on the health and dental care delivery systems. What we do know, however, is that the ACA will usher in access to dental care for many more children outside of the ACA-created online insurance marketplaces – including coverage through most private health insurance plans.

As of Jan. 1, 2014, many of the major reforms created by the Affordable Care Act (ACA) are in place. While the law is lengthy and has many complicated provisions, there are four basic concepts implemented by the law: providing private and public health insurance reforms and patient protections; allowing states to expand Medicaid coverage; requiring U.S. citizens to have health insurance coverage or pay a penalty; and creating marketplaces for health and pediatric dental insurance coverage.

CDA is working with Covered California staff to identify additional training that needs to be provided to the enrollment specialists to help them better support families in accessing the dental benefits that are available to them. In addition, CDA is providing feedback to Covered California on the short-term, and perhaps longer-term, fixes that need to be made to the website to ensure that families who want to buy the dental coverage through the portal can do so efficiently.

After a rocky first few days following its long-anticipated Oct. 1 opening for enrollment, Covered California, the state health insurance marketplace created by the Affordable Care Act (ACA), has now reported some data on the number of consumers who have been able to access health insurance through the new marketplace. CDA remains actively engaged in all of the ACA’s implementation details and can be a resource to members interested in finding out more about the new law and how it may impact dentists and dentistry.

After months of intense preparation, Covered California, the health insurance marketplace created by the Affordable Care Act (ACA), began its open enrollment period on Oct. 1. Consumers can now begin the process of comparing and purchasing affordable medical and dental insurance coverage online, and Covered California is offering in-person and phone support for those who need it.

The ADA has announced the release of the first set of dental performance measures under the Dental Quality Alliance (DQA). The DQA, comprised of multiple stakeholders from across the oral health community, was created to establish a series of oral health care performance measures.

The Affordable Care Act (ACA) amended the federal Fair Labor Standards Act, creating a requirement that employers provide a notice to all employees of the existence of the newly formed insurance marketplace available to them along with information on how to contact the insurance marketplace to request assistance in purchasing coverage if the employee chooses to do so.

California’s Health Benefit Exchange Board, which is tasked with implementing the federal Affordable Care Act in California, held a special meeting on Aug. 8 to focus primarily on issues surrounding the implementation of the pediatric dental Essential Health Benefit. The board upheld its decision to allow only stand-alone dental plans and ruled that it was too close to the date of open enrollment (Oct. 1, 2013) to allow traditional health plans to submit new bids including the pediatric dental benefit at this time. CDA strongly supported the Exchange’s decision to allow stand-alone dental plans.

Covered California, the health and dental insurance online marketplace created by the Affordable Care Act (ACA), has announced the dental plans that will be available for purchase through the Exchange. Six plans were chosen: Anthem Dental; Blue Shield of California; Delta Dental of California; Health Net Dental; LIBERTY Dental Plan; and Premier Access Dental.

Legislation aimed at making sure dental plans put more of their revenues into actual care for patients passed its first legislative hurdle. AB 18 (Pan), championed by CDA, successfully moved through the Assembly Health Committee, overcoming strong objections from dental plans and health plans.

CDA is sponsoring legislation to apply key patient protections and market reforms, including a minimum loss ratio on patient premiums, to dental plans participating in California’s new health plan marketplace, the Covered California health benefit exchange. The Affordable Care Act (ACA) includes many consumer-focused provisions that have already gone into effect, but that only apply to medical plans. Assemblymember Dr. Richard Pan (D-Sacramento), who chairs the Assembly Health Committee, has introduced AB 18, sponsored by CDA, that if passed by the legislature and signed by the Governor, would represent the first time these federal patient protections would be applied to dental plans participating in the small group market inside and outside the new health benefit exchange created by ACA.

If attendance is any indication at a CDA Presents lecture on national health care reform, dentists are eager to learn more about the issue and its impact on their practices as well as employee and personal health coverage. CDA Legislative Affairs Manager Nicette Short presented “National Health Care Reform: How Will It Affect Your Practice?” — a course designed to provide information about the Affordable Care Act and its potential impact on dentists, the oral health care delivery system and the dental benefits market — last month at CDA Presents in Anaheim.

All TDIC Insurance Solutions plans, including Anthem, Kaiser and others, will be impacted by the Affordable Care Act at levels that are yet to be determined. As we move into 2014, plans continue to cite ongoing increases in the cost of providing health care as reasons for recent actions to raise premiums – even before full implementation of ACA. Because of this, TDIC Insurance Solutions is diligently working with experts in the industry to both determine the possible effects and explore alternatives for its health care policyholders.

It has been three years since the passage of the Patient Protection and Affordable Care Act (ACA), and full implementation of the federal health care reform law is now less than eight months away. From nearly the moment of its passage at the federal level, California has been leading other states in working toward its Jan. 1, 2014, implementation, despite the fact that federal regulations providing guidance to states on key implementation details have not all been finalized.

The U.S. Department of Health and Human Services (HHS) recently issued final rules regarding the implementation of the Affordable Care Act (ACA) that included much needed clarification on federal policy related to access to dental care inside and outside of the Health Benefit Exchanges — the health and dental insurance marketplaces created by the ACA.

An annual health care spending report by the Centers for Medicare & Medicaid Services suggests the dental economy is growing; however, the amount spent by consumers remains flat, according to an ADA analysis.

The January 2013 issue of the CDA Update features a recap of the latest Dental Benefits Research Task Force meeting, which included presentations from group practice and network management experts. It also includes a look ahead at CDA Presents The Art and Science of Dentistry in Anaheim. Featured is a panel discussion that can help attendees increase their decision-making skills in terms of technique, materials and procedures.